CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Sanford Clear Lake Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $4,822
  • Cash Discount Price: $4,703
  • vs. Medicare Baseline: 13.53x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Sanford Clear Lake Medical Center is $4,822. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,703. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 13.53x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.
Cash / Self-Pay
$4,703

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,822

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $4,703 (1319%)
Insurance Median: $4,822 (1353%)
Cash: $4,703 (1319% of Medicare)
Ins. Median: $4,822 (1353% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1353% of the Medicare baseline (a markup of 1253%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $1,216 341%
Sanford Health Plan Align $3,016 846%
Security Health Plan $3,233 907%
Ucare $3,239 - $5,165 909%
Wellmark Sd $3,239 909%
Aetna $3,269 - $5,109 917%
Health Partners $3,269 - $4,409 917%
Medicare (plans) $3,269 917%
UnitedHealthcare $3,269 - $4,909 917%
Primewest $3,333 935%
Sanford Health Plan $4,075 - $5,467 1143%
Medica $4,850 - $5,185 1361%
Wellmark $5,056 - $5,115 1419%
Cigna $5,291 1484%
First Choice Health Network $5,291 1484%
Healthez $5,291 1484%
Multiplan $5,291 1484%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Third Avenue South, Clear Lake, SD 57226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals